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目的:评价新柏氏液基薄层细胞学(TCT)技术联合人乳头瘤病毒-DNA(HPV-DNA)检测在子宫颈上皮内瘤变(C IN)诊断和随访中的临床价值。方法:随机选取2009年1~12月在该院妇科门诊进行TCT联合HPV-DNA检测,其中1项或2项异常者,同时进行阴道镜下活体组织检查,并以病理结果为金标准,确诊为子宫颈炎和C IN,并对CIN治疗6月后行TCT及HPV亚型联合检测。结果:随着C IN病理级别的升高,HPV高危型感染率呈上升趋势,低危型HPV感染多见于CINⅠ及其以下病变,P<0.01,差异有统计学意义。在HPV阳性且TCT异常患者中C INⅢ病变检出率最高,为91.67%,仅HPV阳性或TCT阳性患者中子宫颈炎的检出率最高,分别为32.81%,13.54%。CINⅠ、CINⅡ、CINⅢ患者LEEP术后6月HPV亚型及TCT完全转阴率分别为95.92%、89.23%、79.17%。结论:高危亚型HPV感染率随子宫颈病变的加重而逐渐增高。TCT联合HPV亚型检测能够提高CIN的检出率,CIN治疗后有较高的HPV亚型转阴率,对预防子宫颈癌有重要意义。
Objective: To evaluate the clinical value of neo-Burman’s liquid-based cytology (TCT) combined with HPV-DNA in the diagnosis and follow-up of cervical intraepithelial neoplasia (CIN). Methods: The TCT combined with HPV-DNA test was randomly selected in gynecology clinic of the hospital from January to December in 2009. One or two abnormalities were examined by colposcopy and biopsy under colposcopy. The pathological result was the gold standard, For cervicitis and C IN, and CIN treatment of TCT and HPV subtype 6 months after the joint test. Results: As the pathological grade of C IN increased, the rate of high-risk HPV infection was on the rise. Low-risk HPV infection was more common in CINⅠ and below lesions, P <0.01, the difference was statistically significant. The highest detection rate of CINⅢ lesions was in patients with HPV positive and TCT abnormalities, which was 91.67%. The highest prevalence of cervicitis in HPV positive or TCT positive patients was 32.81% and 13.54% respectively. The complete negative conversion rate of HPV subtypes and TCT in CINⅠ, CINⅡ and CINⅢ patients after LEEP were 95.92%, 89.23% and 79.17% respectively. Conclusion: The prevalence of HPV in high-risk subtypes gradually increases with the severity of cervical lesions. TCT combined with HPV subtypes detection can improve the detection rate of CIN, CIN treatment has a higher negative rate of HPV subtype, the prevention of cervical cancer is of great significance.